{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:08:31Z","timestamp":1790129311923,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001262","name":"National Parkinson Foundation","doi-asserted-by":"publisher","award":["1UH3NS095553\u201001A1"],"award-info":[{"award-number":["1UH3NS095553\u201001A1"]}],"id":[{"id":"10.13039\/100001262","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001364","name":"University of Florida Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001364","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The ventral intermediate nucleus (VIM<\/jats:styled-content>) is the target of choice for Essential Tremor (ET<\/jats:styled-content>) deep brain stimulation (DBS<\/jats:styled-content>). Renewed interest in caudal zona incerta (cZI<\/jats:styled-content>) stimulation for tremor control has recently emerged and some groups believe this approach may address long\u2010term reduction of benefit seen with VIM<\/jats:styled-content>\u2010DBS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To compare clinical outcomes and DBS<\/jats:styled-content> programming in the long\u2010term between VIM<\/jats:styled-content> and cZI<\/jats:styled-content> neurostimulation in ET<\/jats:styled-content>\u2010DBS<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>Materials and Methods<\/jats:title>A retrospective review of 53 DBS<\/jats:styled-content> leads from 47 patients was performed. Patients were classified into VIM<\/jats:styled-content> or cZI<\/jats:styled-content> groups according to the location of the activated DBS<\/jats:styled-content> contact. Demographics, DBS<\/jats:styled-content> settings, and Tremor Rating Scale scores were compared between groups at baseline and yearly follow\u2010up to 4 years after DBS<\/jats:styled-content>. Student t\u2010tests and analysis of variance (ANOVA<\/jats:styled-content>) were used to compare variables between groups.<\/jats:p><\/jats:sec>Results<\/jats:title>Relative to baseline, an improvement in ON<\/jats:styled-content>\u2010DBS<\/jats:styled-content> tremor scores was observed in both groups from 6 months to 4 years post\u2010DBS<\/jats:styled-content> (p<\/jats:italic> < 0.05). Although improvement was still significant at 4 years, scores from month 6 to 2 years were comparable between groups but at 3 and 4 years post\u2010DBS<\/jats:styled-content> the outcome was better in the VIM<\/jats:styled-content> group (p<\/jats:italic> < 0.01). Stimulation settings were similar across groups, although we found a lower voltage in the VIM<\/jats:styled-content> group at 3 years post\u2010DBS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>More ventral DBS<\/jats:styled-content> contacts in the cZI<\/jats:styled-content> region do improve tremor, however, VIM<\/jats:styled-content>\u2010DBS<\/jats:styled-content> provided better long\u2010term outcomes. Randomized controlled trials comparing cZI<\/jats:styled-content> vs VIM<\/jats:styled-content> targets should confirm these results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12565","type":"journal-article","created":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T22:48:44Z","timestamp":1509576524000},"page":"75-82","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Ventral Intermediate Nucleus Versus Zona Incerta Region Deep Brain Stimulation in Essential Tremor"],"prefix":"10.1002","volume":"5","author":[{"given":"Robert S.","family":"Eisinger","sequence":"first","affiliation":[{"name":"Department of Neuroscience Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Ramirez\u2010Zamora","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson N.","family":"Cagle","sequence":"additional","affiliation":[{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Giugni","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto R.","family":"Bona","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Monari","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Wagle Shukla","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Hilliard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly D.","family":"Foote","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"},{"name":"Department of Neurosurgery University of Florida College of Medicine Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysegul","family":"Gunduz","sequence":"additional","affiliation":[{"name":"Department of Neurology Center for Movement Disorders and Neurorestoration University of Florida College of Medicine Gainesville FL USA"},{"name":"J. 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